Line of Demarcation
by Webster
Summary: A wickedly cold night may leave Dean with a permanent reminder.  Will he still be able to hunt?
1. Chapter 1

It really would have helped if they could have done the work in daylight, just that once.

The Winchesters generally avoided snow country in deep winter-to protect the car from salt if for no other reason. And when they arrived in Lamar, Colorado the day after Thanksgiving, the ground was dry, the sky was clear and the temperature was well into the forties. It took two days to identity the spirit and find the grave, and Sunday night found them digging it up.

Temperatures drop fast out on the plains, especially on clear nights. At twilight, when they reached the cemetery, it was already well below freezing. They bundled up as well they could and warmed themselves by digging rapidly. By the time their shovels touched coffin, the temperature was two above, and a biting wind swept dust into their eyes.

Which, of course, was when the ghost decided to come out and play.

Dean was on shotgun duty when it appeared. He pumped it full of rock salt, but it reformed rapidly and grabbed him from behind, shoving him downhill away from the grave. Dean tumbled down the hill and landed in a drainage culvert, breaking through the thin ice covering half a foot of running water.

While the ghost attacked Dean, Sam had managed to salt and oil the bones, setting them ablaze just as it reformed in front of his now unarmed brother.

Vengeful spirit laid to rest, Sam ran down after Dean and pulled him out of the water. Fortunately, he'd landed more or less right side up and was only wet from the hips down. His boots sloshed as he climbed back up the hill, but the noise had stopped when they reached the car. Still stunned from the fall, mildly hypothermic, and riding the adrenaline high of a successful hunt, he didn't realize this was a bad thing until he reached the motel and fell over when he tried to walk, feet completely without feeling.

By that time, of course, it was much too late.

"We're not going to amputate anything yet," the elderly doctor explained. "It will take at least a month for the line of demarcation-the barrier between viable and nonviable tissue-to be completely clear, and we want to save as much as possible. There's about a sixty percent chance you'll keep all of the right foot, but you may lose the last joint of the great toe, and you will certainly lose a least a little tissue on the left-possibly as little as the last joints of these toes, possibly all of the toes and part of the foot."

Dean stared straight ahead, eyes glazed from the heavy doses of morphine and the pain it didn't quite cover. Sam hung on every word.

"This is going to be a long recovery. You will be non weight bearing in a wheelchair for at least two weeks until the ankles and mid-feet recover. You will then be able to walk in surgical shoes, though you should still avoid long periods of standing or walking." The doctor held up what looked like a particularly ugly pair of thick-soled velcro sandals with the toes cut off. "Within three weeks, you should consult with a foot surgeon near your home to determine what surgical procedures will be required. You should keep your feet elevated around the clock to reduce swelling, pain and tissue damage. Prop them up with pillows at night. Aloe vera lotion may aid healing as well. Do not, not, not expose them to the cold again this winter. Not even for a minute. Meanwhile, you'll need painkillers."

Sam stuck out a hand for the scripts, then frowned as he read them. "He's going to need that much?"

"Frostbite causes nerve damage. Yes, he'll need it."

The tiny clinic in Lamar had rewarmed and stabilized him, but insisted on sending him to the University of Colorado Medical Center in Denver for more advanced treatment. Two days later, Dean was finally being discharged.

The doctor turned toward the door, giving one final warning. "Your feet will always be more vulnerable to the cold now. Nothing you can do about that but protect them."

Outside the hospital door, an orderly helped Sam pull his drowsy brother out of the wheelchair and into the backseat, placing a duffle under his knees. The wheelchair folded into the trunk, and the bag of medicines, supplies, and instructions Sam placed on the front seat beside him.

He turned the car onto I-25 and headed south.

"Clink. Clink. CLONK."

Sam rose and opened the door. They'd managed to find a ground-floor efficiency with a ramp up to their door and grab bars in the bathroom. Unfortunately, the door was heavy and opened outward right over the ramp and, while Dean could get out on his own, there was no way he could let himself in from the wheelchair.

What the building also had was a lovely rock garden, from which Dean would pick up pebbles with a pair of barbecue tongs and throw them at the door when he wanted in.

"Dean, I told you, use the phone. You're gonna piss off the neighbors. Again."

Dean snorted. Sixteen days and eleven hours after he'd been thrown into that creek, he was taking his amusement where he could. The tongs again hung in their place on the side of his chair, and a plastic shopping bag was slung over one handle. Dean had complained about Scottsdale nonstop since they arrived, the people, the architecture, the unchanging weather, the traffic-not that he could drive in any case. Sam hadn't even consulted him on their destination, just turned the car toward the Valley of the Sun, one of the few places in the country where Dean could spend time outside in December without risking further harm.

The one thing Dean never complained about-never mentioned if he could possibly help it-was his feet.

When in his chair, Dean kept the footrests stretched out in front of him, because, Sam knew, they would swell rapidly if he let them hang down, increasing the already substantial pain. The couch cushions were piled on his bed so he could prop his legs up when lying down. Inside, he kept them dry and uncovered to heal better, but when he went out, he covered the feet in a thin layer of gauze to hide them from public view. They were red up past his ankles, and in some places the skin had peeled as if sunburnt. They remained badly swollen as well. But the toes were the worst of all. Dean's toes looked like marshmallows that had been held too close to the campfire, black and with huge puffy blisters near the base of each one.

"So," Dean offered, "I got us some muffins from the shop down the street. Still warm. You make coffee yet?"

Sam placed a cup on the table as Dean wheeled up to it and put down the muffins. "You've got twenty minutes to eat, then we gotta get in the car if we're going to make your appointment."

Dean's lips tightened.

Finding the right surgeon for Dean's feet had drawn upon all of Sam's research skills. Frostbite severe enough to require surgical consultation was apparently quite rare in 21st century America, and there were only a handful of doctors with experience treating it, none anywhere near Scottsdale. He finally chose a foot surgeon known for his skill at diabetic amputations, reasoning that the neuropathy and circulatory problems diabetics suffered from were not too different from what Dean was going through. After taking some photos of Dean's feet and sending them to a colleague in Saskatchewan for a remote consultation, Dr. Brunetti agreed that he could help.

On their previous visit, however, he'd only renewed the prescriptions for painkillers and antibiotics and ordered Dean to stay in his wheelchair. Today, Dean would to have a bone scan to pin down the line of demarcation, and find exactly how much of his feet he'd lose.

Six hours later, after rolling from the doctor's office to the imaging center at the hospital two blocks away and back again, after a mysterious emergency delayed Dr. Brunetti, after watching Sam drink his seventh cup of coffee, and after rebuffing the fifth attempt at small talk on the part of the fellow gimp next to him in the waiting room, Dean was about to get some answers.

The doctor began with the less-damaged right foot, gentle prodding that nevertheless sent pain like electric shocks up his reawakening nerves.

"The second through fifth toes are clearly viable here, and the rest of the foot... Can you feel that?"

"Yes." Dean replied loudly.

"Good. The only dubious part of the right foot was the first toe, but the scan showed no evidence of osteonecrosis. I think..." He gently tugged at the puffy black blister on the top of Dean's big toe. It came away, revealing pink skin underneath.

"Yes. You'll keep all of your right foot. Now, the left.

"The news here is not so good. The second toe is completely unviable, and it will require what's called proximal amputation-I will remove it at the base. Both the first and third toe have suffered some necrosis, and there I intend to perform an intermediate amputation, that is, one through the middle joint here. The fourth and fifth toes should recover."

Dean blinked, drew in a breath. "Fine. When?"

"Next Monday, right after Christmas."

"And when can I get out of this damned chair?"

"Between now and the surgery, I am permitting you to walk short distances indoors in surgical sandals."

"And after?" Sam asked.

"Having both feet affected presents something of a dilemma when it comes to partial weight bearing... The right foot isn't ready for the demands of using crutches. You'll be off your feet again for two to three days afterward, then another two weeks in the surgical sandal, then the stitches come out and you can wear normal footwear, within certain limitations."

"And what," Dean paused, then spat out the word, "limitations, are those?"

"After surgery, I'll send you to a shoemaker. Meanwhile, I'll write a prescription for diabetic socks. If you're going to be putting weight on these feet, the protection will come in handy."

Sam had a brief surreal image of a sock with a pentagram inscribed on the sole.

"Protection against what?"

"Moisture, possible irritation at the amputation site, things like that.

"Also, I'm renewing your morphine prescription, with an increase in the dose for after the surgery. It's very important that you take it exactly as prescribed and don't start skipping doses because you think you don't need them. If it's too much and it makes you sick, call me. Keeping your pain under control during the healing process can actually reduce the risk of developing phantom pain or other types of chronic nerve pain."

Dean drew in a breath, seemed to be bracing himself.

Sam asked for him, "How will the loss of toes affect him in the long run?"

"He should be able to walk without a limp, in time."

"And run?"

"Well, that's another matter. It might be best if you simply avoid running in the future."

"That doctor doesn't know anything about me. Did you see those folks in the waiting room? All old fat people. Only one there who weighed less than me was a five foot tall woman. You bet they don't run."

Dean wasn't being entirely fair, but he did have a point. He was younger, fitter, and stubborner than most of the surgeon's patients. Besides, the next time a haunted car decided to chase him off a bridge, he wouldn't have much choice about running.

Still unable to walk more than a few steps at a time, Dean spent hours each day doing leg lifts or racing around the neighborhood in his wheelchair. By the time he went to surgery, he'd regained most of his lost stamina. And besides, it kept him from thinking.

Dean woke slowly. There was something white in front of him, a curtain, and he had a dim impression of people moving on the other side.

He blinked rapidly, trying to banish the fog in his mind. It stubbornly refused to clear, but thoughts began appearing out of it. The surgery. Someone adjusting his IV, and then... Nothing, until he woke up here.

He looked down. All he could was a heavy bandage covering him above the ankle, and yellow iodine painted over most of his leg. His throat felt dry, and he coughed twice.

"You're in the recovery room," a woman said calmly. "In a little while, we'll take you back downstairs."

Dean attempted to be charming. "Um," was what came out.

"Why don't you nap a bit more?"

That was the best idea he'd ever heard.

When he woke the second time, the fog had thinned substantially, and someone was maneuvering his stretcher out of its parking space.

"The doctor said it worked out well," Sam told him when he returned to the main floor. "He said that it went exactly as expected."

"Oh. So now I'm down three toenails."

Sam swallowed. "Yeah."

"Well, now that that's dealt with, let's blow this joint. Wasn't there a rumor of a haunt up near Flagstaff?"

In the end, they stayed in Scottsdale for another two weeks, until Dean's stitches came out and he could be fitted with "proper" footwear, whatever that meant. They'd managed to find insurance that would hold up to a month's scrutiny, and Sam took a construction job near their place so they wouldn't have to use fake cards for their expenses. New footwear would put a sizable hole in their reserves, and Dean tried to insist he didn't need them. The look on Dean's face when he first tried to walk in his old biker boots, however, convinced Sam otherwise.

"I'm not giving you back the car keys until you've got some kind of shoes that aren't torturing you," Sam pronounced. "You'd be a hazard, driving like that." Dean admitted defeat almost gracefully, and Sam dropped him off at the shoemaker before heading back to work.

"If it was just the toes, y'know, it'd be easy to fit you," the shoemaker mumbled, examining Dean's blistered and mutilated foot like a work of art. "I'll make you a toe filler insert, one you can put inside any shoes. You can even get these cosmetic things to wear sandals. But the doc says the whole foot's been damaged, both of them. So..."

He reached for the measuring tool. "I'm a size twelve," Dean told him.

"Let's see, right foot first. Yup, twelve and a half. Swollen. Might go down in a few months, might not. Either way, gotta fit what's in front of me." The little old man rubbed his hands together. "Tell me, which parts are the most sensitive?"

When Sam got back to the store, hours later, he found Dean sprawled on a bench outside, holding a lighter to one of his surgical sandals.

"Uh, Dean? Evil shoes?"

"Definitely, definitely evil shoes, man. I think I'm gonna need lighter fluid and kindling, though. Too much plastic."

Dean shoved the only slightly melted sandal into a bag and the lighter back into his pocket, then climbed to his feet, using the back of the bench for balance.

"Are those... sheepskin boots?" Sam eyed the soft, shapeless things in astonishment.

"Yeah, well, better than the damned sandals. I got a pair of tennis shoes for, you know, outdoor stuff."

Sam spread his hands innocently. "Whatever works." Then he tossed the keys.

Fifty-five days and four hours after the Creek Incident, the brothers found themselves in Houston. Joshua, working a job in Ohio, had asked them to track down and interview a possible witness who'd apparently moved down there. It kept them busy for a couple of days, and, of course, didn't require any running.

The next morning, while Sam was still asleep, Dean crept out the door and walked around the back of the motel to a tiny strip of lawn. He paused at the end of it, checked his shoelaces (perfectly tied), adjusted his t-shirt, and began to run.

Fortunately, Dean had a lot of experience at falling down, because he tipped over forwards with the very first stride.

Dean brushed the grass off his knees and tried again.

And fell, again.

"It shouldn't be this hard," he muttered. "People run missing a lot more of their feet than I am. Then again, they might have foot nerves that don't act like fried circuits, too."

He slowed down, went through the motions of running without actually doing it. Found the moment when his body tried to spring off the toes that weren't there.

"Okay, now what? How do I work around that?"

Two hours later, he managed a trot the full length of the field. Peering out the bathroom window, Sam raised both fists in a silent cheer.

A/N: This ridiculously detailed medical fic brought to you by comment memes, Google, and by the surgeon who let me walk without a limp again. (Thanks Dr. K!)


	2. Daily Routine

Every night, Dean brushes his teeth. Dad was always compulsive about dental hygiene. He checks all the weapons, cleans them if they've been used today.

Then, while Sam is showering, he pulls off his boots and inspects his feet. None of the nerves below his ankles work right, and even though his feet seem to hurt all the time, he doesn't always know it when they're actually injured.

He sits down on the bed, facing toward the wall, and unlaces his hiking boots. Over the months since the Creek Incident, his feet have recovered a bit and he can wear normal shoes as long as they fit properly. He sets them down by the bed and pulls out the insoles so they can air overnight, the left with its custom filler that fits into what's left of his toes like a jigsaw piece in its slot. If the FBI ever figured out he wore it, he'd never be able to buy a new one.

He checks the inside of each shoe for pebbles or sharp objects, then leaves the shoes open next to the heater overnight. The feet must stay dry, they told him, and if he doesn't always follow that as strictly as he might in the heat of a hunt, at least he can start the day with dry feet. He pulls off the soft seamless socks designed to keep his feet warm and dry without constricting circulation and places them directly in the laundry. They can't afford to replace these things if he loses a pair to carelessness.

Feet now bare in the empty room, he places the right foot on his left knee and inspects it carefully. The toenails don't need trimming and the one that dropped off after it froze has grown back about halfway. The scrape on his heel from last week is healing cleanly and there are no new wounds. The weird scarlike things from the frostbite blisters are fading slowly, and as he taps the sole and squeezes his toes, the sensations seem a little more normal than they did even last night.

Or so he always hopes.

Next, the left foot. Most of the foot seems healthy, so he inspects the toe stumps, the amputation sites. The amputation was well done, Dean knows, the suture marks placed more precisely than he's ever managed.

As he was warned, he's developed some bizzare calluses on his fourth toe, and on what remains of his first and third. Once, he let the stump of his first toe blister up. Only once.

Dean reaches into the duffel and pulls out his lotion. Gently massages it over the entire foot, starting from the heel and moving up. The skin will crack and bleed, now, if he forgets.

Finally finished, he puts the tools away, gets under the blankets, and turns on the TV.

The shower noises stopped a while ago, but Sam never leaves the bathroom until he knows Dean is ready.


End file.
